AVP, Member Experience

• Serve as business owner for member-facing platforms, including the member app, member portal, CRM, IVR and telephony, chat and messaging, and Voice of Customer tools

• Define business requirements, user stories, and acceptance criteria, and partner with Product and IT through design, build, testing, and release

• Lead user acceptance testing and release readiness for member-facing enhancements, ensuring quality, accessibility, and compliance with HIPAA and other applicable requirements

• Oversee the integrations and data flows that power the member experience, such as eligibility, claims, drug pricing, and pharmacy data, partnering with IT to resolve defects affecting members

• Lead the evaluation, selection, and implementation of member experience vendors and platforms, and hold vendors accountable for performance against contractual commitments

Digital Navigation & Self-Service:

• Design digital navigation tools that help members find lower-cost medications and pharmacies, understand coverage and pricing, track prior authorization status, and enroll in clinical programs

• Expand self-service capabilities that reduce avoidable contacts and increase digital resolution

• Partner with the AVP, Patient Experience to design seamless handoffs between digital channels and Patient Care Advocates, and to equip advocates with the right tools, such as the agent desktop and knowledge base

• Lead journey mapping, usability testing, service design, and continuous improvement efforts that reduce member friction

Performance, Analytics & Value:

• Own the digital member experience scorecard (digital adoption, app and portal engagement, self-service resolution, contact deflection, digital CSAT and NPS, and CES), set targets, and drive accountability for results across functions

• Use analytics, Voice of Customer feedback, and behavioral data to identify root causes, trends, and improvement opportunities

• Build business cases for digital investments and measure their return, including impact on cost-to-serve and client value

• Monitor digital experience performance against client commitments and service level guarantees, partnering with Product, IT, and Operations on improvement plans

Client Partnership:

• Demonstrate AffirmedRx’s digital member experience to clients, benefits consultants, and prospects, including sales pursuits, finalist presentations, and renewals

• Partner with Account Management to address client feedback on the digital experience and support client implementations, including client-specific configurations and member communications

Cross-Functional Initiatives & Change Leadership:

• Lead complex, cross-functional digital initiatives from concept through launch, directing work across teams without direct reporting authority

• Lead change management and adoption for new digital capabilities, including member communications, advocate training, and client rollout

• Build digital experience capability across the organization by advising teams on member-centered design

What you need:

• Bachelor’s degree in Business, Healthcare Administration, Information Systems, or related field required; advanced degree preferred

• 15+ years of progressive experience in digital experience, member/customer experience, product, or healthcare technology, including significant experience leading cross-functional programs

• Pharmacy Benefit Management (PBM), pharmacy benefits, health plan, or healthcare navigation experience required

• Proven experience as a business owner or executive sponsor for member-facing technology, such as app and portal platforms, CRM, IVR and telephony, chat, and Voice of Customer tools

• Strong technical aptitude, including business requirements, agile product development, user acceptance testing, system integrations, and vendor implementations

• Track record increasing digital adoption and self-service, with measurable improvement in NPS, CSAT, or comparable measures

• Strong analytical skills, with experience using data, Voice of Customer insight, and journey analytics to drive decisions

• Proven ability to lead complex cross-functional initiatives and influence leaders without direct authority

• Excellent communication skills, including presenting to clients, benefits consultants, and senior leaders

• Ability to set long-range strategy while staying close to execution in ambiguous, fast-changing environments

• Certified Customer Experience Professional (CCXP) credential preferred

What you get:

• To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes

• To work in a culture where people thrive because when OUR team thrives, OUR business thrives

• Competitive compensation, including health, dental, vision and other benefits

Note:

AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.

Originally posted on Himalayas

• Member Experience Director
• Customer Experience Director
• Digital Experience Design Director
• Healthcare Technology Director

Source: Himalayas